Diagnosis

Finding the underlying cause of galactorrhea can be a complex task because there are so many possibilities.

Testing may involve:

A physical exam, during which your doctor may try to express some of the fluid from your nipple by gently examining the area around your nipple. Your doctor may also check for breast lumps or other suspicious areas of thickened breast tissue.

Analysis of fluid discharged from the nipple, to see if fat droplets are present in the fluid, which can help confirm the diagnosis of galactorrhea.

A blood test, to check the level of prolactin in your system. If your prolactin level is elevated, your doctor will most likely check your thyroid-stimulating hormone (TSH) level, too.

A pregnancy test, to exclude pregnancy as a possible cause of nipple discharge.

Mammography, ultrasound or both, to obtain images of your breast tissue if your doctor finds a breast lump or observes other suspicious breast or nipple changes during your physical exam.

Magnetic resonance imaging (MRI) of the brain, to check for a tumor or other abnormality of your pituitary gland if your blood test reveals an elevated prolactin level.

If your doctor suspects that a medicine you're taking might be the cause of galactorrhea, he or she might instruct you to stop taking the medicine for a short time to assess this possible cause.

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Treatment

When needed, galactorrhea treatment focuses on resolving the underlying cause.

Sometimes doctors can't determine an exact cause of galactorrhea. Your doctor might recommend treatment anyway if you have bothersome or persistent nipple discharge. A medication that blocks the effects of prolactin or lowers your body's prolactin level could help eliminate galactorrhea.

Underlying cause

Possible treatment

Medication use

Stop taking medication, change dose or switch to another medication. Make medication changes only if your doctor says it's OK to do so.

Underactive thyroid gland (hypothyroidism)

Take a medication, such as levothyroxine (Levothroid, Synthroid, others), to counter insufficient hormone production by your thyroid gland (thyroid replacement therapy).

Pituitary tumor (prolactinoma)

Use a medication to shrink the tumor or have surgery to remove it.

Unknown cause

Try a medication, such as bromocriptine (Cycloset) or cabergoline, to lower your prolactin level and minimize or stop milky nipple discharge. Side effects of these medications commonly include nausea, dizziness and headaches.

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